改良全髋关节置换术中无骨水泥髋臼重建的环点柱导向算法:至少5年随访研究。

IF 4.9 1区 医学 Q1 ORTHOPEDICS
Yong Huang, Yixin Zhou, Dejin Yang, Hao Tang, Wang Deng, Shaoyi Guo
{"title":"改良全髋关节置换术中无骨水泥髋臼重建的环点柱导向算法:至少5年随访研究。","authors":"Yong Huang, Yixin Zhou, Dejin Yang, Hao Tang, Wang Deng, Shaoyi Guo","doi":"10.1302/0301-620X.107B6.BJJ-2024-0940.R1","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>The Paprosky acetabular defect classification and associated algorithms cannot adequately guide cementless acetabular reconstruction when using porous metal augments. We aimed to introduce a rim, points, and column (RPC)-orientated cementless acetabular reconstruction algorithm, and hypothesized that patients undergoing this treatment would demonstrate satisfactory mid-term clinical and radiological outcomes.</p><p><strong>Methods: </strong>We enrolled 114 patients (119 hips) who underwent revision total hip arthroplasty between April 2014 and November 2017 by a single surgeon. A minimum five-year radiological follow-up was available for 90 hips (75.6%), with mean clinical and radiological follow-up durations of 6.8 years (SD 0.9) and 6.3 years (SD 1.9), respectively.</p><p><strong>Results: </strong>Harris Hip Scores improved from 35.4 (SD 10.2) preoperatively to 86.0 (SD 10.3) postoperatively (p < 0.001). Fixation modes included rim fixation (33 hips; 27.7%), three-point fixation without point reconstruction (42 hips; 35.3%), three-point fixation with point reconstruction (40 hips; 33.6%), and three-point fixation with pelvic distraction (four hips; 3.4%). Medial wall reconstruction was performed in 20 patients (16.8%). All acetabular components were radiologically stable. Nine-year Kaplan-Meier survival rates for periprosthetic joint infection, any reoperation, and dissatisfaction were 98.28% (95% CI 88.38 to 99.76), 94.37% (95% CI 81.93 to 98.33), and 95.10% (95% CI 84.64 to 98.50), respectively.</p><p><strong>Conclusion: </strong>Acetabular component stability in cementless acetabular reconstruction relies on rim or three-point fixation, with anterior and posterior column continuity providing essential stability. Medial wall reconstruction complements fixation in the RPC algorithm, yielding satisfactory mid-term outcomes.</p>","PeriodicalId":48944,"journal":{"name":"Bone & Joint Journal","volume":"107-B 6 Supple B","pages":"15-22"},"PeriodicalIF":4.9000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Rim-point-column-oriented algorithm in cementless acetabular reconstruction in revision total hip arthroplasty : a minimum five-year follow-up study.\",\"authors\":\"Yong Huang, Yixin Zhou, Dejin Yang, Hao Tang, Wang Deng, Shaoyi Guo\",\"doi\":\"10.1302/0301-620X.107B6.BJJ-2024-0940.R1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>The Paprosky acetabular defect classification and associated algorithms cannot adequately guide cementless acetabular reconstruction when using porous metal augments. We aimed to introduce a rim, points, and column (RPC)-orientated cementless acetabular reconstruction algorithm, and hypothesized that patients undergoing this treatment would demonstrate satisfactory mid-term clinical and radiological outcomes.</p><p><strong>Methods: </strong>We enrolled 114 patients (119 hips) who underwent revision total hip arthroplasty between April 2014 and November 2017 by a single surgeon. A minimum five-year radiological follow-up was available for 90 hips (75.6%), with mean clinical and radiological follow-up durations of 6.8 years (SD 0.9) and 6.3 years (SD 1.9), respectively.</p><p><strong>Results: </strong>Harris Hip Scores improved from 35.4 (SD 10.2) preoperatively to 86.0 (SD 10.3) postoperatively (p < 0.001). Fixation modes included rim fixation (33 hips; 27.7%), three-point fixation without point reconstruction (42 hips; 35.3%), three-point fixation with point reconstruction (40 hips; 33.6%), and three-point fixation with pelvic distraction (four hips; 3.4%). Medial wall reconstruction was performed in 20 patients (16.8%). All acetabular components were radiologically stable. Nine-year Kaplan-Meier survival rates for periprosthetic joint infection, any reoperation, and dissatisfaction were 98.28% (95% CI 88.38 to 99.76), 94.37% (95% CI 81.93 to 98.33), and 95.10% (95% CI 84.64 to 98.50), respectively.</p><p><strong>Conclusion: </strong>Acetabular component stability in cementless acetabular reconstruction relies on rim or three-point fixation, with anterior and posterior column continuity providing essential stability. Medial wall reconstruction complements fixation in the RPC algorithm, yielding satisfactory mid-term outcomes.</p>\",\"PeriodicalId\":48944,\"journal\":{\"name\":\"Bone & Joint Journal\",\"volume\":\"107-B 6 Supple B\",\"pages\":\"15-22\"},\"PeriodicalIF\":4.9000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Bone & Joint Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1302/0301-620X.107B6.BJJ-2024-0940.R1\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bone & Joint Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1302/0301-620X.107B6.BJJ-2024-0940.R1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

目的:Paprosky髋臼缺损分类及相关算法不能充分指导多孔金属增强物的无骨水泥髋臼重建。我们旨在介绍一种边缘、点和柱(RPC)导向的无骨水泥髋臼重建算法,并假设接受这种治疗的患者将表现出令人满意的中期临床和放射学结果。方法:在2014年4月至2017年11月期间,我们招募了114名患者(119髋),由一名外科医生进行了翻修性全髋关节置换术。90髋(75.6%)至少有5年的放射学随访,平均临床和放射学随访时间分别为6.8年(SD 0.9)和6.3年(SD 1.9)。结果:Harris髋关节评分从术前的35.4 (SD 10.2)提高到术后的86.0 (SD 10.3) (p < 0.001)。固定方式包括边缘固定(33髋;27.7%),无点重建的三点固定(42髋;35.3%),三点固定加点重建(40髋;33.6%),以及骨盆牵引三点固定(4髋;3.4%)。内侧壁重建20例(16.8%)。所有髋臼部件放射学稳定。假体周围关节感染、任何再手术和不满意的9年Kaplan-Meier生存率分别为98.28% (95% CI 88.38 ~ 99.76)、94.37% (95% CI 81.93 ~ 98.33)和95.10% (95% CI 84.64 ~ 98.50)。结论:无骨水泥髋臼重建中髋臼假体的稳定性依赖于边缘或三点固定,前后柱连续性提供必要的稳定性。内侧壁重建补充了RPC算法中的固定,中期结果令人满意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rim-point-column-oriented algorithm in cementless acetabular reconstruction in revision total hip arthroplasty : a minimum five-year follow-up study.

Aims: The Paprosky acetabular defect classification and associated algorithms cannot adequately guide cementless acetabular reconstruction when using porous metal augments. We aimed to introduce a rim, points, and column (RPC)-orientated cementless acetabular reconstruction algorithm, and hypothesized that patients undergoing this treatment would demonstrate satisfactory mid-term clinical and radiological outcomes.

Methods: We enrolled 114 patients (119 hips) who underwent revision total hip arthroplasty between April 2014 and November 2017 by a single surgeon. A minimum five-year radiological follow-up was available for 90 hips (75.6%), with mean clinical and radiological follow-up durations of 6.8 years (SD 0.9) and 6.3 years (SD 1.9), respectively.

Results: Harris Hip Scores improved from 35.4 (SD 10.2) preoperatively to 86.0 (SD 10.3) postoperatively (p < 0.001). Fixation modes included rim fixation (33 hips; 27.7%), three-point fixation without point reconstruction (42 hips; 35.3%), three-point fixation with point reconstruction (40 hips; 33.6%), and three-point fixation with pelvic distraction (four hips; 3.4%). Medial wall reconstruction was performed in 20 patients (16.8%). All acetabular components were radiologically stable. Nine-year Kaplan-Meier survival rates for periprosthetic joint infection, any reoperation, and dissatisfaction were 98.28% (95% CI 88.38 to 99.76), 94.37% (95% CI 81.93 to 98.33), and 95.10% (95% CI 84.64 to 98.50), respectively.

Conclusion: Acetabular component stability in cementless acetabular reconstruction relies on rim or three-point fixation, with anterior and posterior column continuity providing essential stability. Medial wall reconstruction complements fixation in the RPC algorithm, yielding satisfactory mid-term outcomes.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Bone & Joint Journal
Bone & Joint Journal ORTHOPEDICS-SURGERY
CiteScore
9.40
自引率
10.90%
发文量
318
期刊介绍: We welcome original articles from any part of the world. The papers are assessed by members of the Editorial Board and our international panel of expert reviewers, then either accepted for publication or rejected by the Editor. We receive over 2000 submissions each year and accept about 250 for publication, many after revisions recommended by the reviewers, editors or statistical advisers. A decision usually takes between six and eight weeks. Each paper is assessed by two reviewers with a special interest in the subject covered by the paper, and also by members of the editorial team. Controversial papers will be discussed at a full meeting of the Editorial Board. Publication is between four and six months after acceptance.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信